Treatment outcome and abandonment rates in a retrospective cohort of children with Burkitt lymphoma in Kano, Nigeria

Abstract

Abstract: Background: Burkitt lymphoma (BL) is highly chemotherapy-sensitive tumor and one of most common childhood cancers in Nigeria. Unlike in high income settings where cure rate is very high, the outcome of children with BL is still poor in low income countries like Nigeria. The main contributing factor to disparity in survival rate is treatment abandonment (TA). This study aimed to determine treatment outcomes and TA rates in a retrospective cohort of Nigerian children admitted with BL.

Methodology: We conducted retrospective charts review of all children (<13 years) with BL admitted at paediatric oncology unit of AKTH between January1st, 2014 and December 31st, 2016. Data extracted from patients’ medical chart records included age, gender, duration of symptoms, clinical stage of tumor, and treatment outcome.

Results: 63 children with diagnosis of BL were admitted during the study time period, of which 56 (88.9%) medical records were retrieved and included in the final analysis. The median age was 8 years (range 3 – 18 years), with a male: female ratio of 1.6:1. Only eight patients completed therapy without relapse (14.3%). Of those who did not complete planned therapy, 7(14.6) died prior to the completion of therapy, leaving 41 (85.4%) who met criteria for TA.

Conclusion: Treatment completion and overall survival rates are poor among children with BL, due to in part high treatment abandonment rate. Leaving outside the treatment is a significant predictor of TA. Local oncology services might need to be decentralized in our environment to substantially reduced abandonment to improve overall survival.

Keywords: Burkitt lymphoma, Treatment outcome, Treatment abandonment, Low income setting